Drug shortages and a focus on the heart

This issue reports on recent shortages of IV opioids and saline, door-to-diuretic time, and in-hospital cardiac arrest.

In our increasingly globalized world, where you can order just about anything online and have it in your hand the next day, you would expect that all the basic necessities of inpatient care would also be easily accessible. That has not always been the case in the past year or so, as our cover story reports. Hospitals around the country have been dealing with shortages of IV saline and opioids, and clinicians and pharmacists have had to change their practices in response.

Speaking of speediness, a recent study suggested that faster administration of diuretics to patients admitted with heart failure exacerbation might improve outcomes. But soon after that, another study found no association between door-to-diuretic time and outcomes. So is there reason to hurry or is it better to take your time? Our story dives into the debate and offers some expert tips for optimizing inpatient heart failure care.

The heart and the speed of treatment are also the focus of the other feature article in this issue. We look at shortcomings in current response to in-hospital cardiac arrest. These events need to be identified more quickly, but even better would be to implement strategies to prevent them in the first place, according to experts.

Prevention is also a key to fighting Clostridium difficile. This month's Success Story describes how one surgical service reduced the spread of C. diff by screening and isolating patients before surgery. Have you found a solution to a common challenge facing hospitalists? ACP Hospitalist is always looking for successes to feature, so please feel free to send us your story (and its supporting data).

Stacey Butterfield